My Sleep Study Report/Results

[RyanMW]

Hey guys.

I posted earlier about being disappointed that my AHI was only 5.5, considering how run down and tired I feel through out the day, how sore I feel when I wake up, etc. You all requested that I get my entire report and post it here, so here it is! Help me decipher this if you could. I hope it isn't too much information. I posted everything that I thought might be relevant. Thanks!

Apnea/Hypopnea Index: 5.7
SaO2 Nadir: 90%
Sleep Architecture: No Stage REM (Normal is 17-28%)
Snoring: Yes
Hypoxia: No
PLMS: No

Total Recording: 540 Minutes
Total Sleep: 292 Minutes
Sleep Efficiency: 83.3%
Sleep Latency: 1.0
REM Sleep: 0%
Stage N1 Sleep: 8.2%
Stage N2 Sleep: 44%
Stage N3 Sleep: 47.7%

Apnea Index: 0.0
Hypopneas: 28
38 Periodic Leg Movements, PLM index of 7.8%

Number of Awakenings: 12
Desaturation Statistics:
> = 2% 47 events
> = 3% 47 events
> = 4% 18 events
> = 5% 6 events

Lowest SA02: 90
Time below 95%: 219.6 minutes
Average duration of hypopnia: 18.6 seconds
Longest: 31.9 seconds
Number in NREM: 28
Number in REM: 0

Average heart rate: 57
Slowest heart rate: 38
Fastest heart rate: 91

Arousal Summary:
Aro Spont: 41
Aro Res: 4
Aro Limb: 2

[RyanMW]

Can anyone help me with this, please? My ENT was not much help at all, so I'm at a loss

[49er]

Hi Ryan,

I am not going to be that much of a help but the AHI score should be 10.43 according to my calculations as it should be 292 (hours slept)/28 (number of hypopneas). And even though your apnea is still mild, this O2 statistic could be why you feel so lousy:

Time below 95%: 219.6 minutes. I realize technically, they don't consider hypoxia until around 89% if I remember correctly. But I also have seen statistics that a normal range is 95% to 99%

I am sure folks with alot more knowledge than me will chime in later today to help you out.

49er

[kaiasgram]

AHI score should be 10.43 according to my calculations as it should be 292 (hours slept)/28 (number of hypopneas).

Not 292 hours, it's 292 minutes of sleep. The AHI in the report is correct.

Ryan, it will be helpful if you register on the forum so it'll be easier to look back at what you posted earlier (when you're registered we can easily click to go back to your previous posts). I remember you but some of the details of your story (in your first post) are fuzzy now.

The first thing that jumps out in your report is the complete absence of REM sleep on the night of the sleep study. For many people sleep apnea is worst during REM sleep. So it could be that your AHI is underrepresented in this report -- I wonder if you normally get some REM at home. If I recall, the idea of a home sleep test was discussed in your first thread.

On the night of the sleep study your AHI was made up entirely of hypopneas -- obstructive events but not complete obstruction. Breathing is compromised and oxygen levels can drop, as yours did at times.

Your periodic limb movement (PLM) index of 7.8% is in the mild category -- might be due to your sleep apnea.

Looking at your report it's hard to imagine that you -- your health -- would not benefit from PAP therapy. And as I said, an important unanswered question is whether you are getting REM sleep at home and if so, what happens to your breathing during REM.

Is there an Interpretation or Conclusion section in your report? Was a diagnosis identified anywhere in the report?

Let us know what specific questions you have.

[RyanMW]

Okay, I registered myself .

As far as a conclusion, the report said mild sleep apnea, with elective CPAP therapy and an attempt at losing weight and practicing better sleep routines.

I am interested also as to why there was zero REM sleep on the report. Assuming that vivid dreams take place during REM sleep, I absolutely get REM sleep each night. I remember multiple vivid dreams each and every night, and if I'm honest, that's a small part of why I'm seeking sleep therapy. I would like to not have those dreams anymore, if possible.

I just wanted to know how to make sense of my report and where I should go from here. I have a sleep study with the CPAP scheduled for this tuesday, November 4th. I have also heard a lot about the benefits of an oral appliance rather than CPAP.

I would just like to not wake up sore and achy every morning with a headache, and not feel tired throughout the entire day. Ironically, I don't feel "myself" or fully rested until late at night, and that has completely destroyed my sleep schedule. Because I feel so badly when I wake up, I tend to delay waking as long as possible, when I can. And because I feel my best late at night, I tend to stay up until the early morning most days. This has been disastrous for my health and career. I'm only 30 and would like to fix this asap.

[JimP]

Patience Ryan

You're only a few nights away from getting this worked out.

[JDS74]

The things I notice about the report are related to the time asleep vs the time of the study compared to sleep latency.

Total Recording: 540 Minutes
Total Sleep: 292 Minutes
Sleep Efficiency: 83.3%
Sleep Latency: 1.0
REM Sleep: 0%

You have nine hours of measurement but only just under 3 hours of sleep. BUT the sleep latency is 1 minute.

Arousal Summary:
Aro Spont: 41
Aro Res: 4
Aro Limb: 2

In the Arousal summary, the report notes 41 spontaneous arousals not related to respiration or limb movement issues. That seems to imply that you are waking up repeatedly all night and getting really fragmented sleep. The spontaneous arousal index is something like 4.6 per hour. its no wonder you never got to REM stage which normally takes about 90 minutes or so to achieve. In my case, my spontaneous arousal rate in my most recent study was 9.1 per hour but of the total time of 8 hours only 52 minutes were spent awake after the first interval of sleep so my fragmentation was less than yours. My sleep doctor and I are exploring what to do the help that situation.

Do you have a pulse oximeter? If you do, it would seem useful to wear it for a few nights to see if you can see anything in the data that would help you get a handle on how often you actually wake up during the night (heart rate will usually increase when you wake up and then slow down as you get back to sleep.)

It would be useful to investigate the cause of these arousals during the night and see if that is treatable.

[Julie]

Couldn't find a note of what pressures you're using...

[Pugsy]

While it's common for us to dream in REM stage sleep we actually can dream in the other stages of sleep as well.
Dreaming isn't limited to REM stage.

Is this as far as you have gone into this process? Getting the diagnostic sleep study? Did you get a sleep study using the mask and machine? Could you please clarify your situation. I don't have any way to go back and read what you wrote prior to registering? I you have another thread you could link to that thread in this thread so we would be able to read it without you having to type it all over again.

By your own admission your sleep hygiene isn't so great....that needs to be worked on regardless of whether you get a cpap machine or not. The best cpap therapy in the world can't take the place of good sleep hygiene.
How many hours of sleep are you averaging? Be honest. Take a hard look.

Having a mild OSA diagnosis doesn't mean that cpap won't help...it might and there's always the possibility that you might have UARS Upper Airway Resistance Syndrome...google it...and if that's the case cpap therapy is still the treatment of choice.

Finally...do you take any meds of any kind even OTC? If so, what are they?

[cnaumann]

The report does not make any sense.

Total Recording: 540 Minutes
Total Sleep: 292 Minutes
Sleep Efficiency: 83.3%
Sleep Latency: 1.0

Sleep Efficiency is total sleep time / total time in bed. I don't know how they could possibly calculate a sleep efficiency of 83% with 5 hours of sleep and 9 hours of recording time. The lack of recorded REM sleep is also puzzling. I kind of question the entire report and study.

How well do you feel you slept at the sleep study?

[RyanMW]

The report does not make any sense.

Total Recording: 540 Minutes
Total Sleep: 292 Minutes
Sleep Efficiency: 83.3%
Sleep Latency: 1.0

Sleep Efficiency is total sleep time / total time in bed. I don't know how they could possibly calculate a sleep efficiency of 83% with 3 hours of sleep and 9 hours of recording time. The lack of recorded REM sleep is also puzzling. I kind of question the entire report and study.

How well do you feel you slept at the sleep study?

Better than usual, but not great.

[RyanMW]

While it's common for us to dream in REM stage sleep we actually can dream in the other stages of sleep as well.
Dreaming isn't limited to REM stage.

Is this as far as you have gone into this process? Getting the diagnostic sleep study? Did you get a sleep study using the mask and machine? Could you please clarify your situation. I don't have any way to go back and read what you wrote prior to registering? I you have another thread you could link to that thread in this thread so we would be able to read it without you having to type it all over again.

By your own admission your sleep hygiene isn't so great....that needs to be worked on regardless of whether you get a cpap machine or not. The best cpap therapy in the world can't take the place of good sleep hygiene.
How many hours of sleep are you averaging? Be honest. Take a hard look.

Having a mild OSA diagnosis doesn't mean that cpap won't help...it might and there's always the possibility that you might have UARS Upper Airway Resistance Syndrome...google it...and if that's the case cpap therapy is still the treatment of choice.

Finally...do you take any meds of any kind even OTC? If so, what are they?

Yes, this is as far as I've gone. I have a sleep study w/ the mask this Tuesday, the 4th.
I sleep about 8-9 hours a night. I wake up constantly, and usually gasping for breath in those hours.

[Pugsy]

I wake up constantly,

Extremely fractured sleep for any reason is going to equal feeling like crap.

While I don't know that you are going to be like I was let me share what I found out at my first sleep study.
My OSA is much, much worse in REM stage sleep. In non REM sleep my AHI was barely 12...not hugely exciting but my desats were. In REM stage sleep my AHI was over 50. I barely made it to REM on that first study to even get enough REM to have any events at all. As it was they had to extrapolate the numbers to get any idea what my AHI was because every time I hit REM the airway would collapse and cause an arousal and bounce me out of REM.

It's common for OSA to be worse in REM and sometimes markedly worse. Maybe you are one of those people. Maybe you are like me and simply not making it to REM stage sleep where maybe your OSA is worse. A lot of maybes for sure but not impossible maybes.
The absence of REM sleep in your sleep study points to horribly fractured sleep. Something is causing arousals that are bouncing you out of the normal sleep cycles.

I know you were hoping for a really big massive eye opening explanation for your problems...other than the absence of REM sleep (which is really an important finding)...there was not anything that would maybe explain your problems but that really doesn't mean much.
Maybe your OSA is worse in REM...maybe you have UARS...either way cpap is the next logical step and worth at least trying.

And please answer the meds question?
There's a reason I asked it.

[RyanMW]

Oh, sorry Pugsy, I must have overlooked your question about medication.

I take 25mg finasteride (generic propecia) and 5mg lexapro, both daily. I've been taking the finasteride for years, and the lexapro since January 2013. I am actually in the process of weaning down from my initial dose of 10mg Lexapro and will be switching to 2.5mg soon. The lexapro is primarily for anxiety and I don't feel like it has helped me, and has made losing weight impossible. I am weaning under the supervision of my primary care physician.

[Sludge]

Oh kaiaaaaaaaaaasmagram.....

It's that thing again....